State regulations for child care centers fall short in preventing childhood obesity

Kansas Health Officer Jason Eberhart-Phillips says it's never too early to start healthy habits. “The earlier we start with children to address the No. 1 public health problem of obesity, the better," he said.

States are failing when it comes to requiring child care operations to provide nutritious foods and exercise.

Kansas is no exception.

The Robert Wood Johnson Foundation, a national advocate for improving health, released a report this week that examined state regulations that require healthy eating or physical activity for child care centers and child care homes.

Nationally, about 75 percent of children between ages 3 and 6 are in some form of nonparental child care, and just over half are in a child center.

Health experts think these child care providers can play an important role in reversing the growing obesity rate among children.

About 25 percent of children between ages 2 and 5 are overweight or obese. In Kansas, about 13 percent of children between ages 2 and 4 are obese.

Regulations lack specifics

Researchers found that most states failed to have model regulations, so they had to look at less stringent and less specific standards. Still, most states performed at average or below-average levels.

LACKING MEASURES

The Robert Wood Johnson Foundation recently released a report that examined Kansas’ regulations regarding requirements for healthy eating and physical activity in day care centers and homes.

Here’s a breakdown on how the state fared:

• Day care centers — Received a C for healthy eating and B- for physical activity. It had eight of the 20 recommended regulations.

• Child care homes — Received a D for healthy eating and C- for physical activity. It had three of the 20 recommended regulations.

Here are some of the recommended regulations that the state does not have, according to the report:

• Children older than 2 are served reduced-fat milk.

• Sugar-sweetened beverages are not served.

• Foods of low nutritional value are served infrequently.

• Child care providers do not withhold active play time as punishment.

• Physical activity education is offered to child care providers.

• At least one provider joins children in active play.

Kansas was among 22 states that received an overall C. Only six states scored lower, with Idaho receiving the only F. The highest grade was a B and only two states — Georgia and Nevada — received it.

Most states, like Kansas, have weakly worded regulations that leave out specifics that could help children stay healthy.

For example, model regulations specify that children should get at least 60 minutes of physical activity per day. But according to the less stringent standards that experts used for the report, states were given credit even if they required some physical activity.

“These findings suggest that most states have a lot of room for improvement in regulations aimed at preventing obesity in young children,” said Sara Benjamin, who conducted the study as a research fellow at Harvard Medical School, in a news release. She now is an assistant professor at Duke University.

“This nation must do a better job at promoting healthy eating and regular physical activity in very young children, especially those in lower-income families who are at high risk for obesity.”

He said Kansas health officials are aware they need to improve state regulations and are reviewing them.

He hopes to have new regulations in place in 2010. But there are a few steps involved, such as a public hearing and legislative approval.

He said the goal is to make the regulations more specific in terms of nutrition and physical activity. For example, he said, they may eliminate sugar-sweetened beverages and require serving reduced-fat milk for children ages 2 and older.

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“We are really good at addressing the acute risks that our precious, young children face in these child care environments around injuries and abuse and things that have these acute, bad outcomes,” Eberhart-Phillips said. “We are only just really starting to appreciate that it’s also neglect and abuse — but the effects are much slower and gradual and not as perceptible — to allow them to eat unhealthful food and to remain inactive for long periods of time.”

According to the report, Kansas had five more regulations for child care centers than child care homes. For example, child care centers are required to provide some physical activity daily and to provide shaded areas for outdoor play, but homes are not.

In Kansas, there are an estimated 105,000 children in child care, and about 58,000 are in a home setting.

Eberhart-Phillips said the new regulations will bring similar standards to all child care operations.

“There’s no reason why kids that are getting care in a home situation should have any less shot at a healthy life than kids who are in a center. Ideally, the standards will be very similar,” he said.

Already exceeding standards

In Douglas County, there are about 6,900 children in day care centers, preschools or day care homes.

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“Most of our providers are aware of the best practices,” she said. “Most go above the minimum standard.”

Flanders said the last time the state updated the regulations was in 1990.

“It’s way past due,” she said.

Flanders said childhood obesity is a problem that needs to be addressed in child care settings and at home.

“Parents have a big role in this, too,” she said. “Parents need to keep them exercising in the evenings and not let them go home and sit in front of the TV. Everybody has to be working on this.”

Flanders suggested that the city of Lawrence could pass even stricter regulations than the state. New York City, for example, recently enacted healthy eating and physical activity regulations that were more stringent than the state’s.

“I think it’s definitely something that we need to be looking at and working on as a community.”

Comments

The kids look like their parents. Pathetically, they think the same as well. All the regulations in the world won't bypass that reality.
But at least they won't die of starvation in the event of a siege.

Food guidelines need to change....I do not consider french fries or catsup as servings of vegetables....but the food guidelines do.

A family member taught at a child care center in Lawrence and it was not unusual to see donuts served for breakfast to one-year-olds, then french fries with catsup (TWO vegetables!) served at lunch.

To those with deregatory comments about the poor and overweight - healthy foods are the most expensive. The price of fresh vegetables and fruits make them special "treats" for many on lower incomes. Think about it, then thank God if you are able to serve your family a healthy diet.

sunny one of those fat women with a food stamp card is me. Though I don't buy steaks as I am a vegan and buy soy meats and soy milk. No doritos or cookies, but ice cream sometimes and a Hershey bar infrequently. Far less than I used to.
I buy frozen vegetables and never fruit. I eat a lot of peanut butter and jam sandwiches.
I have no idea what is on your mind when you write what you do, are you trying to be critical in a helpful sense, are you angry because someone is buying something you can't?
I hate to think of people scrutinizing my basket when I check out. Oh, God, she bought a Hershey bar!

I do think that our child care centers and more importantly, our schools, can and should play a role in fighting childhood obesity. The food that they serve at our schools is not healthy. I went to the usd497 webpage to look up the lunch menus and this is what the kids had to eat as entrees last week: Corn dogs(not healthy), Macaroni and Cheese(not healthy), tuna fish sandwiches(not healthy) refried beans(not healthy), and Pizza Hot Pockets(not healthy). All of these items are loaded with fat and sodium.
There is the obligatory offering of salad and fruit but the majority of kids are going to eat the unhealthy main entree.
And that was just the lunch, do we even want to look at the breakfasts? The most important meal of the day.
Schools definitely need to step it up but since some schools get money from companies to sell their junk, it is unlikely that schools are going to put childhood nutrition before desperately needed money.

As for the daycares, there is no reason a toddler should be eating a donut for breakfast. First of all, think of all that sugar and all those chemicals. Talk about making things rougher on themselves. No wonder teachers look forward to naptime. I would too if I had to deal with a bunch of toddlers hyped up on sugar.

However I do think that, ultimately, it is the parent's responsibility. Get up an extra 30 mins and fix your kids a healthy breakfast. Oatmeal (regular Oatmeal not the sugar ladden kind) takes all of 5 minutes to boil the water and then another 2 minutes to mix the stuff together. NOt hard. Scrambling eggs, also takes less than 10 minutes. It isn't difficult. And there should be no excuse. Especially, if you know that the alternative is that your kid is going to get a donnut for breakfast.

Dena

P.S. As an afterthought, do we, as a nation, really want to start obsessing about our children's weight at age 3. Already by third grade (if not before) girls are worrying about dieting. I can't help but think this obsession with "thinness" is going to get worst if we start telling parents that there kid is fat at 3.

Like it's the state's business? How about leaving it up to the p-a-r-e-n-t-s? They're the ones who chose to park their children in these places all day and pay a lot to do it. Falling for the jive that this is something that the government should manage goes way past nanny state...and if you don't know what's next, then shame on you.

Sometimes the parents have no choice but to "park their children in these places all day" as those parents WORK all day to support their children.

Yes, parents need to take responsibility for what their children eat and that should also include making sure the daycare is serving nutritious meals - no donuts and french fries.

My son went to a great daycare and he actually asks for me to serve peas and make homemade chicken pot pies!

And the whole ketsup as a vegetable is as old as the Reagan era and most people know it is a bunch of B/S and I doubt they include it anymore. Besides, do you know how much one would have to consume for it to count as a true serving?

Obesity is the result of people who must work two jobs or ride the bus thus making the opportunity to purchase and store fresh fruits and vegetables practically impossible. Obesity is the result of people not knowing that an avocado is cheaper than a bag of Doritos. Think about it, an avocado satiates the appetite up to four hours whereas, Doritos lasts 45 minutes....time for another bag, now that can get expensive! Obesity is the result of people thinking that eating breakfast is the most important meal of the day...cause once you eat, your levels dip back down in an hour, time for another snack! Obesity is the result of people eating grain (cereal) while they sit all day in their jobs or in schools without recess, like cows eating grain all day in their cells so they can get fat. Obesity is not the day-care's responsibility. Parents just need to bring their children's food to school. Oh, have you heard the latest backlash, the makers of cow-pus also known as milk are promoting chocolate milk as being healthy. By the way, who's in charge of the Food Pyramid, Department of Agriculture.

Choosing quality child care is a challenging task for families. Parents have a tendency to choose child care by cost and geographical location, forgetting sometimes to ask important questions, such as, "May I see some sample menus?" or "How is active play incorporated into the schedule?" If a child is enrolled in a full day program, both the home and child care environments are important factors to a child's health. In Lawrence there are programs that far exceed the Child and Adult Care Food Program guidelines and incorporate active play daily into their schedule; and there are programs that don't, due to lack of education, regulation, and parent request.

Children need their families and care programs to work together to provide the best environment for their developing bodies and brains. Updating our state regulations to reflect appropriate health and safety standards is one place to start. Right now, only one out of three child care programs even get inspected, so requiring annual inspections for all programs is imperative, too. Our community needs to speak for our children who have no voice and insist that all programs be held responsible to provide a safe and healthy learning environment.